1. Felix, I.
  2. Fritzsche, K.

Article Content

The purpose of the study was to determine whether there are preoperative predictors that indicate a patient's discharge destination from the acute care setting, following primary total hip arthroplasty (THA). Previous studies have demonstrated that various predictors such as age, sex, body mass index, support systems, postoperative function, and comorbidities influence a patient's discharge destination. In this study, the role of preoperative function will be examined. A total of 230 THA patients admitted to the Hospital for Special Surgery were included. Inclusion criteria consisted of (1) admitting diagnosis of osteoarthritis, (2) primary, unilateral, hybrid THA, and (3) physical therapy orders for THA protocol/weight bearing as tolerated. Exclusion criteria included lower extremity amputees or any serious neurological involvement. One hundred forty-two subjects were discharged directly home and 88 were discharged to an inpatient rehabilitation center. This was a prospective, longitudinal descriptive study. The data were collected from completed Hospital for Special Surgery THA functional milestone forms. This form has been previously proven to be valid and reliable. Information on the form included age, height, weight, sex, type of hip prosthesis, weight-bearing status as well as the following: (1) distance ambulated prior to surgery, (2) the use of an assistive device prior to surgery, (3) the need to negotiate stairs, and (4) whether the patient lived alone. A multiple regression analysis was used between dependent variables and predictor variables with Windows KWIKSTAT and SPSS. Statistics run for each group were the [chi]2 and Pearson's correlation. Significant differences were found between the 2 groups in the following categories: (1) preoperative ambulation distance, P = .042; (2) device used for ambulation preoperatively, P = .025; (3) lived alone, P = .001 and (4) age, P = .001. Predictors do exist that help determine whether a patient following a THA is more likely to be discharged home or to an inpatient rehabilitation center. In this study, patients discharged to rehabilitation centers were predominantly older, female, and living alone, presented with 4 or more comorbidities, and ambulated shorter distances using a walker, preoperatively.